Healthcare Provider Details
I. General information
NPI: 1952526626
Provider Name (Legal Business Name): ANTONIO ESPARZA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/16/2007
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 W SAM HOUSTON SUITE1
PHARR TX
78577-5217
US
IV. Provider business mailing address
900 W SAM HOUSTON SUITE1
PHARR TX
78577-5217
US
V. Phone/Fax
- Phone: 956-783-1000
- Fax: 956-783-9679
- Phone: 956-783-1000
- Fax: 956-783-9679
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | H7411 |
| License Number State | TX |
VIII. Authorized Official
Name:
ANTONIO
ESPARZA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 956-783-1000